RCM

About the role

This role involves regular communication with residents and their families regarding their care plans, treatment protocols, and health conditions. The incumbent attends morning meetings to facilitate team communications and ensures that residents' needs are met promptly.

Responsibilities

• Communicate regularly with residents and their families about Plans of Care, PT, OT, and other treatment protocols.
• Attend and participate in morning meetings/stand up to facilitate communications with the team.
• Answer residents' questions about their care, treatment plans, illness progression, and all other issues to ensure they feel safe and secure in the care provided.
• Monitor and adjust resident's statuses based on changing needs and conditions.
• Organize and prioritize daily work by assessing new, current, and discharging residents' needs in area(s) of responsibility.
• Complete documentation as required.
• Perform utilization review activities to provide resident appropriate, timely, and cost-effective care.
• Career coordination with resident, care providers, facilities financial services, and third-party payers.
• Oversee all admissions and discharge activities. Coordinate referrals both to and from our facility.

Requirements

Ability to relate positively, effectively, and appropriately with residents, families, staff, and professional colleagues. Accurate charting and ability to complete necessary paperwork in a timely manner. Ability to work independently and exercise sound judgment in interactions with physicians, providers, payers, and residents and their families. Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including residents/families/caretakers, physicians, nurses, and other ancillary partners. Must have excellent time management skills to develop organized work processes in a high volume environment with rapidly changing priorities. Intermediate computer skills. Competence maintaining professional, respectful, honest interactions with residents/families and staff and partners.

Qualifications

• Education and/or Experience: Bachelor’s Degree in Nursing or Social Work. Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable. Two (2) years of clinical nursing experience preferred.
• Knowledge: Knowledge of Medicare, Medicaid, and other relevant healthcare programs and benefits.
• PCC Knowledge: Knowledge of policies and procedures related to patient care.
• Languages: Ability to read and understand technical procedures and policy manuals.
• Mathematical Skills: Ability to apply basic mathematical concepts.
• Reasoning Ability: Ability to solve practical problems.
• Certificates, Licenses, Registrations: LVN/LPN valid license or RN valid license. CCM certification a plus. Maintain all required continuing education/licensing.
• Physical Demands: Standing and/or walking very frequently, sitting occasionally, reaching with hands and arms frequently, talking and/or hearing very frequently, lifting up to 50 pounds frequently, climbing, balancing, stooping, kneeling, crouching or crawling occasionally, close, distance, color, peripheral, and depth perception in vision.
• Work Environment: Noise level in the work environment is usually low to moderate.